Healthcare Provider Details
I. General information
NPI: 1679496756
Provider Name (Legal Business Name): BETWEEN BLOOMS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
57 SEMINOLE FIELDS DR
BROADWAY NC
27505-8016
US
IV. Provider business mailing address
57 SEMINOLE FIELDS DR
BROADWAY NC
27505-8016
US
V. Phone/Fax
- Phone: 919-336-1631
- Fax: 919-439-7895
- Phone: 919-336-1631
- Fax: 919-439-7895
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIN
HOWARD
Title or Position: OWNER/PROVIDER
Credential: LCMHC, NCC
Phone: 919-897-6560